性激素替代疗法在冻融胚胎移植患者中的临床治疗效果及对母儿结局的影响研究

Study on the effect of sex hormone replacement therapy in the treatment of freeze-thaw embryo transplantation and its effect on maternal and infant outcomes

目的探讨性激素替代疗法在冻融胚胎移植患者中的临床治疗效果及对母儿结局的影响。方法选取2017年2月至2018年2月沧州市人民医接收的363个周期冻融胚胎移植的患者作为研究对象。按患者意愿分为两组,对照组249个周期,予以来曲唑进行治疗;研究组114个周期,在对照组基础上加之使用性激素替代。比较两组患者基线资料、实验室结果以及临床结局。结果两组患者体重指数、年龄、bFSH、E2、T、bLH水平、不孕时长比较,差异无统计学意义(P>0.05),两组患者冷冻胚胎复苏率、子宫内膜厚度、冷冻胚胎优胚率、转化日LH、P、E2激素水平比较,差异无统计学意义(P>0.05),研究组患者妊娠率、种植率高于对照组患者,差异无统计学意义(P>0.05),两组移植胚胎数、多胎妊娠率、HCG阳性率、自然流产率、异位妊娠率比较,差异无统计学意义(P>0.05)。结论在选取冻融胚胎移植患者的内膜准备方案过程中,选用性激素替代疗法,效果显著,值得在临床上多加广泛推广与应用。

Objective To investigate the clinical effect of sex hormone replacement therapy on freeze-thaw embryo transplantation and its effect on maternal and infant outcomes.Methods 363 patients received cycles of freezing and thawing embryo transfer in our hospital from February 2017 to February 2018 were selected and divided into the control group(n=249)and the study group(n=114)according to their willingness.The control group received letrozole treatment,on which basis the study group received sex hormone replacement therapy.Basic indicators,laboratory results and clinical outcomes were compared between the two groups.Results There were no statistically significant differences in the body mass,age,bFSH,E2,T,bLH level and length of infertility between the two groups(P>0.05).There were no statistically significant differences in the frozen embryos recovery rate,endometrial thickness,frozen embryos ratio of embryo,transformation,LH,P and E2 hormone levels on the transplantation day between the two groups(P>0.05).The pregnancy rate and planting rate was higher in the study group than that in the control group,without statistically significant differences(P<0.05).There were no statistically significant differences in the number of implanted embryos,multiple pregnancy rate,HCG positive rate,rate of spontaneous abortion and ectopic pregnancy rate between the two groups(P>0.05).Conclusions Sex hormone replacement therapy has a significant effect in the selection of intima preparation scheme for patients to perform frozen and thawed embryo transplantation,thusly worthy of clinical application and promotion.